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The process of searching sources to support one’s study with high-quality and relevant evidence is crucial for any research. Thus, it is important to consider which databases should be used, what key words would best describe the direction of search, and what specific features the chosen studies should have. One can benefit from perusing various scientific databases to ensure the most fitting choice of sources; however, by spreading the search too wide, one can easily lose the boundaries of the intended research area. Thus, it could be advised to use only one-two databases to better concentrate on the quality of the sources and not their overall quantity. Moreover, one needs to understand fully how to perform academic search properly and use the correct keywords to ensure best results. The specific topic of the study and research question should be formulated prior to employing the search to provide better results. Thus, this paper describes the literature research process on the topic of early diagnosis of depression in young adults staying in primary care.
The Amount of Evaluated Databases
For this study, 20 databases were evaluated in order to determine which is the best suited for the chosen research questions. These databases include PubMed, The Lancet, Medscape, The Cochrane Collaboration, Google Scholar, Scopus, JSTOR, ScienceDirect, and others. Each database was evaluated in terms of its general purpose and area of research, the amount of sources it provides, their overall quality, and the ability to adjust the search for specific purposes using filters. Among all 20 directories, PubMed was chosen as the most fitting for the specified research topic.
Search Process Description
The process of search revolved around the chosen topic – early diagnosis of depression in young adults who reside in primary care. Key words included “depression,” “young adults,” “clinical setting,” “early diagnostic,” “depression diagnostic tools,” “depression in healthcare facilities.” To ensure that the sources are up to date, time filter was applied: each article should not be published earlier than 5 years ago. Literary reviews and meta-analyses were excluded from the search entirely, as they did not provide substantial evidence for the chosen topic. Among the offered resources, those were preferred which described real clinical setting studies, trials, and interventions. In the next paragraph, some relevant studies will be discussed to provide a better insight into the search process and ensure better understanding of the topic.
Clinical Topics that Determined the Source Search
The clinical topics for this research are the incidence of depression in young (18-40 years old) adults and how to diagnose this disorder early in the primary care setting using screening tools such as PHQ9. In recent decades, enough data has emerged indicating that depressive disorders that appear as comorbidities in the primary care setting have a negative impact on the clinical course of the treatment. Patient outcomes, their future functionality and quality of life can be severely affected by the presence of undiagnosed depression. In addition, available scholarly papers on the problem of young adult depression indicate significant clinical polymorphism and atypia of these conditions. Depressive disorders can act in isolation or in combination with other psychopathological manifestations. Different mechanisms are involved in the formation of these states, and their prognosis largely depends on the nosology within which they are realized, on psychological and personal components. This necessitates further study of the clinical and dynamic characteristics of depressive disorders in young adults in order to optimize diagnosis and therapy.
Overall, depressive disorders in young adults represent a rather heterogeneous group in which each population subgroup requires specific early diagnostic measures. Jha et al. (2019) report that “evaluation from 16 primary care clinics show that 17.3% of all patients screened positive for depression, and of positive screens, 56.1% had clinician-diagnosed depressive disorder” (p. 326). This study (2018) provides evidence that well-designed and evidence-based interventions can significantly affect the rates of patient depression recognition and the success of subsequent treatment. The clinical setting of primary care allows healthcare professionals evaluate the patients for the signs of depression in time if tailored, scientifically-proven strategies are applied. Lee at al. (2020) provide “a systematic review of existing guidelines for the management of depression in adults with major depressive or bipolar disorder” (p. 683). The authors (2020) found that the currently employed depression diagnosis strategies face various challenges during the development and implementation stages, and there is no adequate planning or measurement system for them. For example, low- and middle-income countries suffer especially greatly, as the guidelines implemented there are significantly less likely to get reviewed and authorized by a multidisciplinary counsel.
Depression can manifest at any age, with symptoms gradually developing over time which makes it difficult to track the exact point of the disorder’s appearance. Middle-aged persons, according to government figures, are more vulnerable to developing symptoms of depression. These data, on the other hand, can be linked to this age group’s highest level of social activity and, as a result, their highest level of need for medical assistance. In the etiology and diagnosis of depression, social factors play a vital role. Older age groups, for example, are not used to seeking help from psychiatrist or therapists and have a history of ignoring mental health issues. In addition, this is a factor that affects children and teenagers in their younger years. Due to the emotional or mental infancy and, consequently, their incapacity to identify and distinguish their emotional condition, their depressed manifestations are frequently neglected by physicians, families, children or adolescents themselves. It is important to adjust the early diagnostic strategies to fit a concrete age subgroup in order to provide better care results and facilitate positive patient outcomes.
There is the issue of pregnant and postpartum women – they face significant stress due to the process of preparing for and giving birth to one or multiple children. Moreover, postpartum depression has been historically strongly associated with an increased risk of suicide and infanticide in new mothers. The study by Smithson and Pignone (2017) supports “the benefits of screening for depression in all adults, including older patients and pregnant and postpartum women, when coupled with appropriate resources for management of disease” (p. 807). The authors (2017) state that a reliable and well-designed diagnostic strategy should become the first step in managing the depression in primary care. Moreover, collaborative care approaches can be used to improve patient outcomes during depression treatment.
Thus, the need for early diagnosis of depressive disorders in patients in primary care, in particular young adults, becomes obvious. The main methods for diagnosing depression are a thorough collection of complaints and anamnesis, a physical examination of the patient, during which the manifestation of any signs of depression and anxiety is taken into account. However, one of the most effective tools for assessing the patient’s the mental state and presence of depressive disorders are special questionnaires such as PHQ9 or Beck’s Depression Inventory. Ferenchick et al. (2019) report that “primary care providers play a central role in managing depression and concurrent physical comorbidities, and they face challenges in diagnosing and treating the condition” (p. 365). In the first part of their two-series study, the authors (2019) discuss the possible strategies of screening and diagnosing depression in adults in the primary care setting. They emphasize the need to use evidence-based guidelines and provide specific recommendations for clinical practice, underlining the need to implement tailored approaches.
Why PubMed Fits the Database Selection Criteria
PubMed is a worldwide system for searching the Medline database, a US National Library of Medicine electronic resource that contains abstracts from numerous periodicals dating back to 1966. It is intended for anyone interested in using high quality information to make decisions about health and healthcare specifically, which is why it was chosen as primary database for the research. This database has filters that allow one to narrow the search criteria by key parameters such as publication time and type. PubMed is widely regarded as one of the best databases for evidence-based medicine, including detailed summaries and full-text copies of systematic reviews with excellent methodology quality. In addition, it contains the results of published studies, randomized trials, and unstructured investigations on the therapy of the most typical medical disorders and ailments, which was very useful for studying depression. It can be concluded that PubMed is the most suited for this study as it is the most advanced electronic database required for skilled medical practice today.
References
Ferenchick, E. K., Ramanuj, P., & Pincus, H. A. (2019). Depression in primary care: Part 1—screening and diagnosis.BMJ, l794. Web.
Jha, M. K., Grannemann, B. D., Trombello, J. M., Clark, E. W., Eidelman, S. L., Lawson, T., Greer, T. L., Rush, A. J., & Trivedi, M. H. (2019). A structured approach to detecting and treating depression in primary care: Vitalsign6 project.The Annals of Family Medicine, 17(4), 326–335. Web.
Lee, Y., Brietzke, E., Cao, B., Chen, Y., Linnaranta, O., Mansur, R. B., Cortes, P., Kösters, M., Majeed, A., Tamura, J. K., Lui, L. M., Vinberg, M., Keinänen, J., Kisely, S., Naveed, S., Barbui, C., Parker, G., Owolabi, M., Nishi, D., … McIntyre, R. S. (2020). Development and implementation of guidelines for the management of depression: A systematic review.Bulletin of the World Health Organization, 98(10). Web.
Smithson, S., & Pignone, M. P. (2017). Screening adults for depression in primary care.Medical Clinics of North America, 101(4), 807–821. Web.
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